• Journal of Nutrition and Health
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• v.54 no.3
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• pp.247-261
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• 2021

Purpose: This study was conducted to identify the association between insulin resistance and the major dietary patterns of Korean adults. Methods: This study used data from the 2015 Korea National Health and Nutrition Examination Survey. The subjects were 2,276 adults aged 19 to 64 years old. Based on the food frequency questionnaire data, 112 food items were reclassified into 30 food groups. The principal component analysis method was applied to identify major dietary patterns. We used homeostatic model assessment of insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) value as indicators of insulin resistance. The association between major dietary patterns and insulin resistance was investigated using logistic regression analysis. Results: Three major dietary patterns were identified and assigned descriptive names based on the food items with high loadings: 'healthy Korean meal pattern', 'western meal pattern', and 'white rice, alcohol, meat pattern'. As the 'white rice, alcohol, meat pattern' score increased, significant increasing trends for fasting glucose concentration and HOMA-IR and a significant decreasing trend for QUICKI were observed after adjusting for age and sex. The odds ratio of insulin resistance according to the 'healthy Korean meal pattern' and the 'western meal pattern' were not statistically significant. the 'white rice, alcohol, meat pattern' showed a significant positive association with the risk of insulin resistance after adjusting for covariates. Conclusion: These results suggest that the 'white rice, alcohol, meat pattern' is positively associated with the risk of insulin resistance. The white rice, alcohol, meat pattern was related to the high consumption of alcohol together with rice or meat. This pattern was also associated with the high intake of sodium and low intakes of vitamin C, calcium, potassium, and dietary fiber. To confirm the association, further longitudinal studies are required.

• Journal of Digital Convergence
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• v.17 no.2
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• pp.293-301
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• 2019

The purpose of this study is to redefine 7 social exclusion factors and to derive association between social exclusion factors and depression of middle and older elderly, focused on gender differences. The elderly aged over 50 years old were extracted from the data of the Korean Longitudinal Study of Ageing (KLoSA) in 2016. The data was analyzed by descriptive analysis, chi-squared test, and binary logistic regression analysis, using SAS 9.4. As a result, the elderly who were excluded from labor, residence, health, and relationship were found to be associated to depression. In addition, male with resident exclusion were associated with depression compared to non-excluded. Therefore, it is necessary to improve the local community programs in which elderly people can participate in labor and cultural activity. It is necessary to improve labor and culture exclusion by increasing the participation opportunities of various cultural programs. In addition, it is needed to establish specific guidelines for eliminating the social exclusion of overall elderly.

• 한국노년학
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• v.38 no.1
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• pp.243-259
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• 2018

The purpose of this study is to investigate the moderating effect of home-based welfare facilities for older adults on the associations between the activities of daily living (ADL) / instrumental activities of daily living (IADL) and the depressive symptoms among Koreans in later life. Multilevel analysis was conducted with Korean Longitudinal Study of Aging 5th data and the public report about welfare facilities from Ministry of Health and Welfare in Korea. Samples were 4,139 older adults over 65 years old. The dependent variable was depressive symptoms, and individual level independent variables were ADL and IADL. The ratio of home-based welfare facilities out of 10,000 older adults in each city and province was the moderator. As a result, the effects of ADL on depressive symptoms vary according to the proportion of elderly welfare facilities out of the old population in the community. In specific, the older adults who live in the place where the elderly welfare facility rate was higher were less affected by ADL. Also, the more IADL people had, the more depressive symptoms they had. However, the interaction effect between IADL and the proportion of home-based welfare facilities was not significant. It suggests that delivering welfare services helping ADL through the home-based welfare facilities may be useful for decreasing depressive symptoms. Moreover, considering the proportion of facilities and older population will be helpful to make the welfare facilities efficiently work.

• 한국노년학
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• v.40 no.1
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• pp.91-109
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• 2020

This study aims to investigate the interdependence of Korean middle and old-aged couples in the association between exercise and life satisfaction through grip strength trajectory. Data were drawn from the nationally representative Korea Longitudinal Study of Aging (KLoSA) collected from 2006 to 2016. The sample included couples over 45 years of age in the first wave and participated in all six waves of the survey (Ncouple=1,997). There were three steps for analyses: correlation, parallel latent growth curve model, tests of indirect effects of the mediation paths. Covariates included in the models were husbands and wives' characteristics (age, education, work status, chronic diseases, marital satisfaction, contact frequency with friends or neighbors) and couple's household income. Results showed husbands' and wives' life satisfaction and grip strength were interdependent upon each other. Also, exercise participation of both husbands and wives was associated with both husbands' and wives' life satisfaction via the initial level of grip strength of husbands. Moreover, exercise participation of only husbands was associated with wives' life satisfaction through the initial grip strength of husbands. These results suggest the aging processes of middle and old-aged couples need to be understood in the context of gender dynamics and couple interdependence.

• Korean Journal of Radiology
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• v.23 no.12
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• pp.1269-1280
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• 2022

Objective: This study aimed to evaluate the usefulness of quantitative indices obtained from deep learning analysis of gadoxetic acid-enhanced hepatobiliary phase (HBP) MRI and their longitudinal changes in predicting decompensation and death in patients with advanced chronic liver disease (ACLD). Materials and Methods: We included patients who underwent baseline and 1-year follow-up MRI from a prospective cohort that underwent gadoxetic acid-enhanced MRI for hepatocellular carcinoma surveillance between November 2011 and August 2012 at a tertiary medical center. Baseline liver condition was categorized as non-ACLD, compensated ACLD, and decompensated ACLD. The liver-to-spleen signal intensity ratio (LS-SIR) and liver-to-spleen volume ratio (LS-VR) were automatically measured on the HBP images using a deep learning algorithm, and their percentage changes at the 1-year follow-up (ΔLS-SIR and ΔLS-VR) were calculated. The associations of the MRI indices with hepatic decompensation and a composite endpoint of liver-related death or transplantation were evaluated using a competing risk analysis with multivariable Fine and Gray regression models, including baseline parameters alone and both baseline and follow-up parameters. Results: Our study included 280 patients (153 male; mean age ± standard deviation, 57 ± 7.95 years) with non-ACLD, compensated ACLD, and decompensated ACLD in 32, 186, and 62 patients, respectively. Patients were followed for 11-117 months (median, 104 months). In patients with compensated ACLD, baseline LS-SIR (sub-distribution hazard ratio [sHR], 0.81; p = 0.034) and LS-VR (sHR, 0.71; p = 0.01) were independently associated with hepatic decompensation. The ΔLS-VR (sHR, 0.54; p = 0.002) was predictive of hepatic decompensation after adjusting for baseline variables. ΔLS-VR was an independent predictor of liver-related death or transplantation in patients with compensated ACLD (sHR, 0.46; p = 0.026) and decompensated ACLD (sHR, 0.61; p = 0.023). Conclusion: MRI indices automatically derived from the deep learning analysis of gadoxetic acid-enhanced HBP MRI can be used as prognostic markers in patients with ACLD.

• Sleep Medicine and Psychophysiology
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• v.24 no.1
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• pp.38-45
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• 2017

Objectives: Sleep disturbance is a very rapidly growing disease with aging. The purpose of this study was to investigate the prevalence of sleep disturbances and its predictive factors in a three-year cohort study of people aged 60 years and over in Korea. Methods: In 2012 and 2014, we obtained data from a survey of the Korean Social Life, Health, and Aging Project. We asked participants if they had been diagnosed with stroke, myocardial infarction, angina pectoris, arthritis, pulmonary tuberculosis, asthma, cataract, glaucoma, hepatitis B, urinary incontinence, prostate hypertrophy, cancer, osteoporosis, hypertension, diabetes, hyperlipidemia, or metabolic syndrome. Cognitive function was assessed using the Mini-Mental State Examination for dementia screening in 2012, and depression was assessed using the Center for Epidemiologic Studies Depression Scale in 2012 and 2014. In 2015, a structured clinical interview for Axis I psychiatric disorders was administered to 235 people, and sleep disturbance was assessed using the Pittsburgh Sleep Quality Index. The perceived stress scale and the State-trait Anger Expression Inventory were also administered. Logistic regression analysis was used to predict sleep disturbance by gender, age, education, depression score, number of coexisting diseases in 2012 and 2014, current anger score, and perceived stress score. Results: Twenty-seven percent of the participants had sleep disturbances. Logistic regression analysis showed that the number of medical diseases three years ago, the depression score one year ago, and the current perceived stress significantly predicted sleep disturbances. Conclusion: Comorbid medical disease three years previous and depressive symptoms evaluated one year previous were predictive of current sleep disturbances. Further studies are needed to determine whether treatment of medical disease and depressive symptoms can improve sleep disturbances.

• Safety and Health at Work
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• v.4 no.1
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• pp.52-62
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• 2013

Objectives: To investigate the association between psychological distress and obesity among law enforcement officers (LEOs) in the United States. Methods: Self-reported data on psychological distress based on six key questions were obtained from LEOs who participated in the National Health Interview Survey (2004-2010). We used Prochaska's cut-point of a Kessler 6 score ${\geq}5$ for moderate/high mental distress in our analysis. Mean levels of body mass index (BMI) were compared across three levels of psychological distress. Results: The average age of LEOs (n = 929) was 39.3 years; 25% were female. Overall, 8.1% of LEOs had moderate or high psychological distress; 37.5% were obese (BMI ${\geq}30$). Mean BMI increased with increasing psychological distress (no distress, BMI = $27.2kg/m^2$; mild distress, $27.6kg/m^2$; and moderate/high distress, $33.1kg/m^2$; p = 0.016) after adjustment for age, race, income, and education level among female officers only. Physical activity modified the association between psychological distress and BMI but only among male LEOs (interaction p = 0.002). Among male LEOs reporting low physical activity, psychological distress was positively associated with BMI ($30.3kg/m^2$ for no distress, 30.7 for mild distress, 31.8 for moderate/high distress; p = 0.179) after adjustment, but not significantly. This association was not significant among males reporting high physical activity. Conclusion: Mean BMI significantly increased as psychological distress increased among female LEOs. A longitudinal study design may reveal the directionality of this association as well as the potential role that physical activity might play in this association.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.2
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• pp.460-469
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• 2020

The purpose of this study was to examine the predictive factors for health promotion behaviors of older adults in rural areas. A theoretical substruction was constructed to test hypothetical models based on Pender's health promotion model. The data was collected from 199 older adults aged 65 years or older, who resided in G city, by using a structured questionnaire. The questionnaires contained items on individual characteristics, health literacy, self efficacy and health promoting behavior. The data was analyzed with a t-test, ANOVA, Pearson's correlation coefficients and hierarchical multiple regression analysis using SPSS 20.0 for Windows. The predictive factors for the health promotion behavior were the number of health information channels (β=.16, p=.031) and self efficacy (β=.53, p<.001). The total explanatory power of these factors was 30.8%. A nursing intervention plan for improving health promoting behaviors of older adults should be developed and applied, with a focus on self-efficacy and health information channels. Further longitudinal studies are needed to help confirm relevant measurement of the level of health promoting behaviors of older adults.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.3917-3925
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• 2012

Background: The relationship between postmenopausal hormone therapy (HT) and invasive breast cancer has been extensively investigated, but that with breast carcinoma in situ (BCIS) has received relatively little attention. The aim of our present study was to review and summarize the evidence provided by longitudinal studies on the association between postmenopausal HT use and BCIS risk. Methods: A comprehensive literature search for articles published up to May 2012 was performed. Prior to performing a meta-analysis, the studies were evaluated for publication bias and heterogeneity. Relative risk (RR) or odds ratio (OR) values were calculated using 14 reports (8 case-control studies and 6 cohort studies), published between 1986 and 2012. Results: There was evidence of an association between ever postmenopausal estrogen use and BCIS based on a random-effects model (RR = 1.25, 95% confidence interval (CI) = 1.01, 1.55). However, we found no strong evidence of an association between ever postmenopausal estrogen combined with progesterone use and BCIS using a randomeffects model (RR = 1.55, 95% CI = 0.95, 2.51). Furthermore, our analysis showed a strong association between "> 5 years duration" of estrogen or estrogen combined with progesterone use and BCIS. Furthermore, current use of any HT is associated with increased risk of BCIS in cohort studies. Additional well-designed large studies are now required to validate this association in different populations.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.623-628
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• 2009

Purpose: In cases where nasal fractures involve frontal process of maxilla or perpendicular plate of ethmoid, 4 - 5 days of nasal packing may not provide sufficient support for avoiding displacement after packing removal. Therefore a single Kirschner - wire(K - wire) is used as an internal splint when nasal fractures involve the above two areas. Methods: Thirty five patients during the last 3 practical years were treated with a K -wire pinning according to the anatomic locations of nasal fractures. We performed a retrospective study using 13 nasal fractures out of total 35 patients. Among 13 cases, 10 patients involved frontal process of maxilla, and 3 patients were diagnosed as bilateral nasal side wall fractures accompanied with fractures of perpendicular plate of ethmoid. One patient of the last three cases had been augmented with dorsal silicone implant long before the trauma. We analyzed the anteroposterior displacement of key stone area and the width between both lateral walls by comparing immediate postoperative radiographs with 2 month follow - ups. To reduce the errors, the same measurements were taken by two different inspectors, and the mean of each inspector's measurements was compared. Patient satisfaction was analyzed using a questionnaire regarding the esthetic and functional outcomes. Results: Ten patients underwent a longitudinal K - wire fixation in submucoperiosteal plane underneath the frontal process of maxilla. And three patients underwent a transverse K - wire fixation from the one side of lateral wall to the perpendicular plate of ethmoid and to the other side of lateral wall. The mean postoperative anteroposterior displacement of the key stone area measured by two inspectors were 1.84% and 3.06%; mean narrowing of bony pyramid were 1.33% and 1.48%, respectively. Subjective satisfaction scores regarding the esthetic appearance and the maintenance of nasal shape compared with immediate post - operative state with the long term ones were not different (p>0.05). Conclusion: K - wire pinning after closed reduction is a reliable and useful method for the treatment of nasal fractures involving frontal process of maxilla or perpendicular plate of ethmoid. This is because it achieves longer intranasal support after reduction. This method also leaves conspicuous external scar, and minimal soft - tissue injury.